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SPIRITUAL CARDIOLOGY  


PRAYER
: THE RELIGIOUS PRESCRIPTION

Is spirituality good for your health?  Should physicians prescribe prayer and religious participation along with nitroglycerin and coronary bypass?  Our patients think so.  80% of Americans feel that religious factors can improve physical health, and 56% say that faith has helped them recover from illness.  Scientific research tells us that our patients are right.  In 22 of 27 studies, attendance at religious services was correlated with better health.  75% of 212 studies showed a positive effect of religious commitment on health outcomes.  These numbers are compelling, but just what is it about religion that prevents disease and speeds healing?  What is the religious connection?  Let’s go back in time to find out.

The health benefits of religion were recognized by physicians thousands of years ago, but at that time we didn’t call them MDs, we called them priests.  Eating pork and shellfish was a good way to get an intestinal infection.  The rabbi proscribed against this, and Orthodox Jews follow this tradition today.  At the time of Christ, a good marriage and strong family unit had survival value.  It still does, and Family Togetherness remains a principle of all churches.  Strong family support will improve two-year survival following bone marrow transplantation from 20 to 54%, just as having a spouse or close confidant will decrease your chance of sustaining a second heart attack by a factor of three.  Group Participation is something that we are genetically programmed for; we need other people if we are to enjoy optimum health. The socially isolated have 10-year disease and death rates 3-fold greater than those who regularly participate in group activities.  Being in a group will lower the rise in blood pressure and adrenaline that occurs with stress. A recent Dartmouth Medical Center study shows us that people who regularly participate in group activities are three times more likely to survive bypass surgery. Group Participation is provided for by religion; all you have to do is go to church or church related activities.  All religions encourage Altruism, and from the medical perspective, doing well unto others just might keep you from arriving in Heaven prematurely.  95% of us get a “good feeling” when we help others, and this is also good for our health.   University of Michigan researchers studied the effects of life style and behavior on health outcomes in 3,000 men living in Tecumseh.  They found that men who did volunteer work once a week were two and a half times less likely to die over ten years as those who did none.  Comfort and Solace speed the healing process following major surgery. Patients who spend 20 minutes with the anesthesiologist pre-operatively, and gain an appreciation of his concern and compassion, need less pain medications following surgery and leave the hospital 2.6 days early (How’s that for cost effective medicine?)  Dartmouth bypass patients who experience Comfort and Solace from their religious beliefs are three times more likely to survive surgery.  If they also happen to Participate in Groups (i.e. Do they worship at church?) then their likelihood of leaving the hospital whole and intact rose by a factor of ten.  Men and women who attend church are more likely to follow a Healthy Lifestyle, and are less likely to smoke, be sedentary, or overindulge in food and alcohol. It seems that when we know that others care about us, we are less likely to engage in behaviors that are harmful to our health. Perhaps the most powerful effect of religion on health has to do with Prayer.  The health benefits of prayer are difficult to study and understand, so let’s go into a little more detail on this subject. 

 

The Power of Prayer 

Can prayer prevent disease and speed healing?  Here again, our patients think so.  In a 1995 Gallop pole, 80% of Americans said that they pray for good health.  In medical lingo, when a patient is doing poorly and his outlook is grim, we say that he “doesn’t have a prayer”.  Is this figurative speech or scientific fact?  Researchers have studied the health effects of prayer in terms of Remembered Wellness, The Relaxation Response, and Intercessory Prayer with Divine Intervention.  Let’s take a look at their work.  

       Prayer as Remembered Wellness 

When we believe that we will get better, and especially when we take a step to ensure that we will get better, then we are more likely to get better.  Hope and the feeling that you can affect your health future will stimulate the immune system, lower levels of the stress hormones, and trigger our rest and repair mechanisms.  Hope and belief are healing, and medical science understands this.  The “placebo effect” refers to the fact that research study subjects who receive a biologically inactive placebo substance (the control group) will get better 30% of the time.  In long term studies, subjects who take all or most of their placebos (presumably they think that the placebo may help) live longer and suffer fewer illnesses than control group members who frequently miss doses.  If a doctor whom you personally trust and respect gives you a placebo, then symptomatic improvement or healing will occur in 60-70% of us. 

Personally taking the step that you believe will help you can trigger an internal placebo effect.  Harvard cardiologist Herbert Benson (author of The Relaxation Response and Timeless Healing ) calls this Remembered Wellness, the innate ability of man to influence his health through his beliefs.  There are examples of Remembered Wellness in our everyday lives.  Why does your headache improve 30 seconds after you take an aspirin, well before any of the drug has reached your bloodstream?  Why did your two-week attack of bronchitis suddenly improve the day after you finally called your physician for an appointment?  You took a step toward getting better, so you got better.  You experienced Remembered Wellness.

 We don’t pray for our health because our mothers told us to.  We pray because we believe that prayer will help us.  When we pray, we trigger Remembered Wellness, and the stronger our belief, the greater will be the positive effect upon our health.  But prayer is more than just a placebo.

        Prayer as The Relaxation Response

Upon hearing the first snarl of the Saber-toothed Tiger, primitive man’s heart rate and blood pressure rose.  Stress hormones gushed into his bloodstream, raising blood sugar and fat levels to feed his now taut muscles.  Blood was shunted away from the skin and digestive system, and to the muscles where it would be needed.  With his pupils dilated, mind on full alert, and blood clotting systems fully activated, he was ready to fight or take flight from the big cat.  Once back in the safety of his cave, the threat over, primitive man’s stress response systems stood down. Primitive man rested, he repaired, and then he went on with his life.  Fight or flight, followed by rest and repair; Mother Nature’s plan for survival and good health.

The threats to primitive man, the stresses that we are designed to handle, were short lived, real, and physical.  Modern man’s threats are chronic, primarily psychological, and more perceived than real, and we aren’t designed to handle them.  Concerns over money and social standing, problems at the office, and fear of violence on the city streets leaves us constantly on full physical alert.  A marriage we didn’t work on, and strained relations with children we were too busy to nurture, leaves us without a cave to crawl into.  We aren’t faced with just one tiger a week.  As far as our bodies are concerned, we are fighting off every animal in the forest, from dawn until dusk, even into our dreams.

Rest, repair, and reproductive hormones are shunted off in favor of the stress hormones, cortisol and adrenaline, giving us the modern diseases of hypertension, stroke, and diabetes, leaving us with insomnia, heart disease, reduced immune function, and a susceptibility to cancer unique in the history of mankind. An engine never rested soon burns out, and that is what chronic stress is doing to our health today.

 There is a way to neutralize the fight or flight response, lowering heart rate, blood pressure and muscle tension.  Stress hormone levels fall, our mind quiets, and oxygen needs decrease by 50%, allowing us to rest and repair.  This state of biochemical grace, which doctors discovered and named The Relaxation Response, is achieved by quietly focusing your mind on a single word or phrase, while breathing slowly and passively ignoring intrusive thoughts.  Does this sound familiar?  If not, please say “Hail Mary full of grace” over and over in your mind.  You don’t have to practice Transcendental Meditation or Hatha Yoga to benefit from this recent medical discovery.  All you have to do is pray.  Prayer is healing.  It is the off switch to stress, and religion has known this for centuries.  Judaism, Islam, and Christianity all contain silent, repetitive prayers, originally designed to speed healing of the sick.

       Intercessory Prayer & Divine Intervention

The appeal to a higher power to directly improve the physical health of another is known as Intercessory Prayer.  We pray for our family members routinely, especially when they are sick.  30% of doctors and a greater percentage of nurses will pray for their patients.  We pray for our friends, and some people will pray for total strangers! 

We’d like to think that some of our prayers are being answered, but how do we know for sure?  You hear of amazing medical turnarounds attributed to prayer (and I think that I’ve seen a few), but how do we know that it wasn’t the drugs, the doctors, the technology, or just good luck?  Also, people likely to be prayed for are likely to be religious people themselves. Their personal faith provides them with Remembered Wellness, and their private prayer leads to The Relaxation Response. Worship at church helps via Group Participation.  If they like to help others, then they get the health benefits of Altruism. Can Intercessory Prayer improve on this?  Scientific studies, carried out primarily by physicians, show that it can.

If Intercessory Prayer helps humans, then it ought to help plants and animals too.  Corn and grain seeds sprout up 30% more rapidly when they are prayed for.  If the seeds are first made “sick” by exposing them to a toxin, then the relative benefit of prayer is enhanced.  Surgically damaged worms regenerate more rapidly when they are prayed for.

Lowering blood pressure and heart rate, and increasing the level of the cardiac protective hormone DHEA is a big help to heart patients.  Neurosurgeon Norman Shealy, inventor of the TENS unit, has shown that DHEA levels rise by up to one third following Intercessory Prayer.  In his book, Miracles Do Happen, he describes how intercession can affect vital signs.  A volunteer is hooked up to sensitive measuring instruments in one room.  When people three rooms away begin to pray for him, his heart rate and blood pressure fall; when they stop, his vital signs rise back to baseline.

Corn, vital signs, and hormone levels are fine, but can intercession help with the tough diseases like cancer and cardiac insufficiency?  In a 1969 study, 10 of 18 childhood leukemia patients were randomly selected to be prayed for.  Ten families in another city were given the child’s name, and asked to pray for them on a daily basis.  The 10 “prayer” and the 8 “control” children received the same medical care.  Neither the children, their parents, nor their health care providers knew which children were being prayed for and which were not.  After 15 months of prayer, the status of the children was reviewed.  7 of the 10 prayed for children were alive, while only 2 of the 8 control children had survived.  By scientific standards this was a small study, and the benefits of prayer did not reach statistical significance, but it certainly makes you think.  Dr. Randolph Byrd studied the effects of Intercessory Prayer on 393 patients in a coronary care unit.  Half of the patients were assigned by a computer to be the subject of prayer.  Their name, and a brief description of their illness, was given to 5 volunteers scattered across the country, who were asked to pray for “their” patient on a regular basis.  Updates were provided to the intercessors on a periodic basis, allowing them to focus their prayer on any new problems that “their” patient was experiencing.  The study was “double-blind” and scientifically sound.  The same team of health care providers cared for all 393 patients.  Neither the patients or the doctors and nurses caring for them knew who was being prayed for and who wasn’t. The code was broken after 10 months and the effect of intercession analyzed.  26 parameters of medical outcome were followed, and in 20 a significant benefit of Intercessory Prayer could be demonstrated.  Overall the prayed for group did better, and in 3 areas the effect was striking.  8% of the usual care group required antibiotics; only 1.6% of the prayed for patients needed these drugs.  Pulmonary edema, a severe congestion of the lungs due to cardiac pump failure, occurred in 9% of the control patients, but in only 3% of those prayed for.  Respiratory arrest, requiring placement of an airway tube and artificial ventilation, complicated the course of 6% of the control group, but not one of the 192 coronary patients who were prayed for needed to be placed on a mechanical ventilator!   

In statistical terms, “analysis of the data suggested that 16% of the variance in overall outcome could be attributed to the effect of prayer”.  In our terms, this means that prayer works.  My degree is in medicine, not theology, but I like my patients to do 16% better, and I really don’t like to see them on ventilators.  When they are sick in the CCU, their families certainly hear about Dr. Byrd’s study. 

Is there room for religion in medicine today?  If we want our patients to do ten times better following bypass and not go on ventilators, than I think there is.  The religious lifestyle worked 2000 years ago, will be associated with better health 2000 years from now, and it can be today.  Prayer provides the biological benefits of Remembered Wellness and The Relaxation Response, and opens the door to Divine Intervention.  We technodoctors try our best, but there are limits to what we can do.  There may not be these limits to what you and your God can do. 

  

                                                                                                                                                                James C. Roberts MD FACC FAARFM

 

SPIRITUAL CARDIOLOGY  

PRAYER: THE RELIGIOUS PRESCRIPTION

Is spirituality good for your health?  Should physicians prescribe prayer and religious participation along with nitroglycerin and coronary bypass?  Our patients think so.  80% of Americans feel that religious factors can improve physical health, and 56% say that faith has helped them recover from illness.  Scientific research tells us that our patients are right.  In 22 of 27 studies, attendance at religious services was correlated with better health.  75% of 212 studies showed a positive effect of religious commitment on health outcomes.  These numbers are compelling, but just what is it about religion that prevents disease and speeds healing?  What is the religious connection?  Let’s go back in time to find out.

The health benefits of religion were recognized by physicians thousands of years ago, but at that time we didn’t call them MDs, we called them priests.  Eating pork and shellfish was a good way to get an intestinal infection.  The rabbi proscribed against this, and Orthodox Jews follow this tradition today.  At the time of Christ, a good marriage and strong family unit had survival value.  It still does, and Family Togetherness remains a principle of all churches.  Strong family support will improve two-year survival following bone marrow transplantation from 20 to 54%, just as having a spouse or close confidant will decrease your chance of sustaining a second heart attack by a factor of three.  Group Participation is something that we are genetically programmed for; we need other people if we are to enjoy optimum health. The socially isolated have 10-year disease and death rates 3-fold greater than those who regularly participate in group activities.  Being in a group will lower the rise in blood pressure and adrenaline that occurs with stress. A recent Dartmouth Medical Center study shows us that people who regularly participate in group activities are three times more likely to survive bypass surgery. Group Participation is provided for by religion; all you have to do is go to church or church related activities.  All religions encourage Altruism, and from the medical perspective, doing well unto others just might keep you from arriving in Heaven prematurely.  95% of us get a “good feeling” when we help others, and this is also good for our health.   University of Michigan researchers studied the effects of life style and behavior on health outcomes in 3,000 men living in Tecumseh.  They found that men who did volunteer work once a week were two and a half times less likely to die over ten years as those who did none.  Comfort and Solace speed the healing process following major surgery. Patients who spend 20 minutes with the anesthesiologist pre-operatively, and gain an appreciation of his concern and compassion, need less pain medications following surgery and leave the hospital 2.6 days early (How’s that for cost effective medicine?)  Dartmouth bypass patients who experience Comfort and Solace from their religious beliefs are three times more likely to survive surgery.  If they also happen to Participate in Groups (i.e. Do they worship at church?) then their likelihood of leaving the hospital whole and intact rose by a factor of ten.  Men and women who attend church are more likely to follow a Healthy Lifestyle, and are less likely to smoke, be sedentary, or overindulge in food and alcohol. It seems that when we know that others care about us, we are less likely to engage in behaviors that are harmful to our health. Perhaps the most powerful effect of religion on health has to do with Prayer.  The health benefits of prayer are difficult to study and understand, so let’s go into a little more detail on this subject. 

 

The Power of Prayer 

Can prayer prevent disease and speed healing?  Here again, our patients think so.  In a 1995 Gallop pole, 80% of Americans said that they pray for good health.  In medical lingo, when a patient is doing poorly and his outlook is grim, we say that he “doesn’t have a prayer”.  Is this figurative speech or scientific fact?  Researchers have studied the health effects of prayer in terms of Remembered Wellness, The Relaxation Response, and Intercessory Prayer with Divine Intervention.  Let’s take a look at their work.  

       Prayer as Remembered Wellness 

When we believe that we will get better, and especially when we take a step to ensure that we will get better, then we are more likely to get better.  Hope and the feeling that you can affect your health future will stimulate the immune system, lower levels of the stress hormones, and trigger our rest and repair mechanisms.  Hope and belief are healing, and medical science understands this.  The “placebo effect” refers to the fact that research study subjects who receive a biologically inactive placebo substance (the control group) will get better 30% of the time.  In long term studies, subjects who take all or most of their placebos (presumably they think that the placebo may help) live longer and suffer fewer illnesses than control group members who frequently miss doses.  If a doctor whom you personally trust and respect gives you a placebo, then symptomatic improvement or healing will occur in 60-70% of us. 

Personally taking the step that you believe will help you can trigger an internal placebo effect.  Harvard cardiologist Herbert Benson (author of The Relaxation Response and Timeless Healing ) calls this Remembered Wellness, the innate ability of man to influence his health through his beliefs.  There are examples of Remembered Wellness in our everyday lives.  Why does your headache improve 30 seconds after you take an aspirin, well before any of the drug has reached your bloodstream?  Why did your two-week attack of bronchitis suddenly improve the day after you finally called your physician for an appointment?  You took a step toward getting better, so you got better.  You experienced Remembered Wellness.

 We don’t pray for our health because our mothers told us to.  We pray because we believe that prayer will help us.  When we pray, we trigger Remembered Wellness, and the stronger our belief, the greater will be the positive effect upon our health.  But prayer is more than just a placebo.

        Prayer as The Relaxation Response

Upon hearing the first snarl of the Saber-toothed Tiger, primitive man’s heart rate and blood pressure rose.  Stress hormones gushed into his bloodstream, raising blood sugar and fat levels to feed his now taut muscles.  Blood was shunted away from the skin and digestive system, and to the muscles where it would be needed.  With his pupils dilated, mind on full alert, and blood clotting systems fully activated, he was ready to fight or take flight from the big cat.  Once back in the safety of his cave, the threat over, primitive man’s stress response systems stood down. Primitive man rested, he repaired, and then he went on with his life.  Fight or flight, followed by rest and repair; Mother Nature’s plan for survival and good health.

The threats to primitive man, the stresses that we are designed to handle, were short lived, real, and physical.  Modern man’s threats are chronic, primarily psychological, and more perceived than real, and we aren’t designed to handle them.  Concerns over money and social standing, problems at the office, and fear of violence on the city streets leaves us constantly on full physical alert.  A marriage we didn’t work on, and strained relations with children we were too busy to nurture, leaves us without a cave to crawl into.  We aren’t faced with just one tiger a week.  As far as our bodies are concerned, we are fighting off every animal in the forest, from dawn until dusk, even into our dreams.

Rest, repair, and reproductive hormones are shunted off in favor of the stress hormones, cortisol and adrenaline, giving us the modern diseases of hypertension, stroke, and diabetes, leaving us with insomnia, heart disease, reduced immune function, and a susceptibility to cancer unique in the history of mankind. An engine never rested soon burns out, and that is what chronic stress is doing to our health today.

 There is a way to neutralize the fight or flight response, lowering heart rate, blood pressure and muscle tension.  Stress hormone levels fall, our mind quiets, and oxygen needs decrease by 50%, allowing us to rest and repair.  This state of biochemical grace, which doctors discovered and named The Relaxation Response, is achieved by quietly focusing your mind on a single word or phrase, while breathing slowly and passively ignoring intrusive thoughts.  Does this sound familiar?  If not, please say “Hail Mary full of grace” over and over in your mind.  You don’t have to practice Transcendental Meditation or Hatha Yoga to benefit from this recent medical discovery.  All you have to do is pray.  Prayer is healing.  It is the off switch to stress, and religion has known this for centuries.  Judaism, Islam, and Christianity all contain silent, repetitive prayers, originally designed to speed healing of the sick.

       Intercessory Prayer & Divine Intervention

The appeal to a higher power to directly improve the physical health of another is known as Intercessory Prayer.  We pray for our family members routinely, especially when they are sick.  30% of doctors and a greater percentage of nurses will pray for their patients.  We pray for our friends, and some people will pray for total strangers! 

We’d like to think that some of our prayers are being answered, but how do we know for sure?  You hear of amazing medical turnarounds attributed to prayer (and I think that I’ve seen a few), but how do we know that it wasn’t the drugs, the doctors, the technology, or just good luck?  Also, people likely to be prayed for are likely to be religious people themselves. Their personal faith provides them with Remembered Wellness, and their private prayer leads to The Relaxation Response. Worship at church helps via Group Participation.  If they like to help others, then they get the health benefits of Altruism. Can Intercessory Prayer improve on this?  Scientific studies, carried out primarily by physicians, show that it can.

If Intercessory Prayer helps humans, then it ought to help plants and animals too.  Corn and grain seeds sprout up 30% more rapidly when they are prayed for.  If the seeds are first made “sick” by exposing them to a toxin, then the relative benefit of prayer is enhanced.  Surgically damaged worms regenerate more rapidly when they are prayed for.

Lowering blood pressure and heart rate, and increasing the level of the cardiac protective hormone DHEA is a big help to heart patients.  Neurosurgeon Norman Shealy, inventor of the TENS unit, has shown that DHEA levels rise by up to one third following Intercessory Prayer.  In his book, Miracles Do Happen, he describes how intercession can affect vital signs.  A volunteer is hooked up to sensitive measuring instruments in one room.  When people three rooms away begin to pray for him, his heart rate and blood pressure fall; when they stop, his vital signs rise back to baseline.

Corn, vital signs, and hormone levels are fine, but can intercession help with the tough diseases like cancer and cardiac insufficiency?  In a 1969 study, 10 of 18 childhood leukemia patients were randomly selected to be prayed for.  Ten families in another city were given the child’s name, and asked to pray for them on a daily basis.  The 10 “prayer” and the 8 “control” children received the same medical care.  Neither the children, their parents, nor their health care providers knew which children were being prayed for and which were not.  After 15 months of prayer, the status of the children was reviewed.  7 of the 10 prayed for children were alive, while only 2 of the 8 control children had survived.  By scientific standards this was a small study, and the benefits of prayer did not reach statistical significance, but it certainly makes you think.  Dr. Randolph Byrd studied the effects of Intercessory Prayer on 393 patients in a coronary care unit.  Half of the patients were assigned by a computer to be the subject of prayer.  Their name, and a brief description of their illness, was given to 5 volunteers scattered across the country, who were asked to pray for “their” patient on a regular basis.  Updates were provided to the intercessors on a periodic basis, allowing them to focus their prayer on any new problems that “their” patient was experiencing.  The study was “double-blind” and scientifically sound.  The same team of health care providers cared for all 393 patients.  Neither the patients or the doctors and nurses caring for them knew who was being prayed for and who wasn’t. The code was broken after 10 months and the effect of intercession analyzed.  26 parameters of medical outcome were followed, and in 20 a significant benefit of Intercessory Prayer could be demonstrated.  Overall the prayed for group did better, and in 3 areas the effect was striking.  8% of the usual care group required antibiotics; only 1.6% of the prayed for patients needed these drugs.  Pulmonary edema, a severe congestion of the lungs due to cardiac pump failure, occurred in 9% of the control patients, but in only 3% of those prayed for.  Respiratory arrest, requiring placement of an airway tube and artificial ventilation, complicated the course of 6% of the control group, but not one of the 192 coronary patients who were prayed for needed to be placed on a mechanical ventilator!   

In statistical terms, “analysis of the data suggested that 16% of the variance in overall outcome could be attributed to the effect of prayer”.  In our terms, this means that prayer works.  My degree is in medicine, not theology, but I like my patients to do 16% better, and I really don’t like to see them on ventilators.  When they are sick in the CCU, their families certainly hear about Dr. Byrd’s study. 

Is there room for religion in medicine today?  If we want our patients to do ten times better following bypass and not go on ventilators, than I think there is.  The religious lifestyle worked 2000 years ago, will be associated with better health 2000 years from now, and it can be today.  Prayer provides the biological benefits of Remembered Wellness and The Relaxation Response, and opens the door to Divine Intervention.  We technodoctors try our best, but there are limits to what we can do.  There may not be these limits to what you and your God can do. 

  

                                                                                                                                                                    James C. Roberts MD FACC FAARFM